Prophylaxis after Exposure to Coxiella burnetii

Details

• Alternative Title:
  Emerg Infect Dis
• Personal Author:
  Moodie, Claire E. ; Thompson, Herbert A. ; Meltzer, Martin I. ; Swerdlow, David L.
• Description:
  Coxiella burnetii is a category B bioterrorism agent. We numerically evaluated the risks and benefits from postexposure prophylaxis (PEP) after an intentional release of C. burnetii to the general population, pregnant women, and other high-risk populations. For each group, we constructed a decision tree to estimate illness and deaths averted by use of PEP/100,000 population. We calculated the threshold points at which the number of PEP-related adverse events was equal to the cases averted. PEP was defined as doxycycline (100 mg 2x/day for 5 days), except for pregnant women, where we assumed a PEP of trimethoprim-sulfamethoxazole (160 mg/800 mg 2x/day) for the duration of the pregnancy. PEP would begin 8-12 days postexposure. On the basis of upper-bound probability estimates of PEP-related adverse events for doxycycline, we concluded that the risk for Q fever illness outweighs the risk for antimicrobial drug-related adverse events when the probability of C. burnetii exposure is >or=7% (pregnant women using trimethoprim-sulfamethoxazole = 16%).
• Subjects:
  Adult Anti-Bacterial Agents Bioterrorism Child Coxiella Burnetii Coxiella Burnetti Decision Trees Doxycycline Female Heart Diseases Heart Valve Diseases Humans Immunocompromised Host Infant, Newborn Male Models, Biological Pregnancy Pregnancy Complications, Infectious Pregnant Women Prophylaxis Q Fever Research Risk-benefit Assessment Risk Assessment Risk Factors Trimethoprim, Sulfamethoxazole Drug Combination

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• Source:
  Emerg Infect Dis. 14(10):1558-1566
• Pubmed ID:
  18826819
• Pubmed Central ID:
  PMC2609859
• Document Type:
  Journal Article
• Volume:
  14
• Issue:
  10
• Collection(s):
  Emerging Infectious Diseases
• Main Document Checksum:
  urn:sha256:f25491e9d6b6b1a9e4fddd2c8372fd6a7fb13cb621b981e9a7c2248a3ef5e6ed
• Download URL:
  https://stacks.cdc.gov/view/cdc/3208/cdc_3208_DS1.pdf
• File Type:
  [PDF - 176.89 KB ]